Classics of Traditional Chinese Medicine Dr. Kenneth Wang OMD, Ph.D., L.Ac. E-mail: acuhherbinfo@gmail.com acuherb.us Huangdi neijing 黃帝內經 “The Inner Classic of the Yellow Emperor” (168 B.C) The most important book of Chinese medicine and a very important book of Daoist practice is the Yellow Emperor's Classic of Medicine (Huangdi neijing 黃帝內徑), said to have been compiled by the mythical Yellow Emperor 黃帝. It consists of two parts, the Suwen 素問 "questions of fundamental nature" and the Lingshu 靈樞 "spiritual pivot", a book also called Zhenjing 針經 "Classic of Acupuncture" because the latter is its main content . The book is concepted as a dialog between the Yellow Emperor and Qi Bo 歧伯, his doctor. It has 18 volumes, all 162 articles. The main contributions of the book are: 1) a whole conception is stressed. 2) theory of yin-yang, & five elements are applied to physiology, pathology, diagnosis & treatment of disease 3)stressing viscera & meridians 4)under the guidance of above-mentioned theories, descriptions are made on 6 evils, 7 emotions, diet, internal damage 5)descriptions are made on 4 diagnosis methods. 6)treatment and principles are determined. 1.上古天真論 黃帝乃問於太師歧伯:「余聞上古之人,春秋皆度百歲,而動作不衰。今時之人,年半百 而動作皆衰者,時世異耶?人將失之耶?」歧伯對曰:「今時之人不然也,以酒為漿,以 妄為常,醉以入房,以欲竭其精,以耗散其真, 不知持滿,不時御神,務決其心,逆於生 樂,起居無節,故半百而衰也。」 The universal truth During his reign, the Yellow Emperor discoursed on medicine, health, lifestyle, nutrition, and Taoist cosmology with his ministers Qi Bo, Lei Gong, and others. Their first discussion began with the Yellow Emperor inquiring, "I have heard that in the days of old everyone lived one hundred years without showing the usual signs of aging. In our time, however, people age prematurely, living only fifty years. Is this due to a change in the environment, or is it because people have lost the correct way of life?" Qi Bo replied, "... These days, people have changed their way of life. They drink wine as though it were water, indulge excessively in destructive activities, drain their jing (the body's essence that is stored in the kidneys) and deplete their qi (energy). They do not know the secret of conserving their energy and vitality. Seeking emotional excitement and momentary pleasures, people disregard the natural rhythm and order of the universe. They fail to regulate their lifestyle and diet, and sleep improperly. So it is not surprising that they look old at fifty and die soon after..." In ancient times people behaved according to the teaching of preserving health of the sages: (Xu Xie Zei Feng, Bi zhi you shi, Tian Dan Xu Wu, Zhen Qi Cong Zhi, Jing Shen Nei Shou, Bing An Cong Lai.) All evils of various seasons are harmful to people, they attack the body when it is general debility. And they should be defended anytime and everywhere. When one is completely free from wishes, ambitions and distracting thought, indifferent to fame and gain, the True energy (Zhen Qi) will come in the wake of it. When one concentrates his spirit internally and keeps a sound mind, how can any illness occur? Huangdi asked: “People are unable to have any child when they are old, whether it is due to the exhaustion of their energy or it is the natural law of physiology?” Qibo answers: For woman 7 years—kidney qi becomes prosperous, her milk teeth fall off, permanent teeth emerge. 27 37 47 57 67 77 For Man 18 28 38 48 58 68 78 88 Chapter 2 Si Qi Tiao Shen Da Lun (On prevention health in accordance with the four seasons) Following the principles of yin yang ensures life, while breaking them may lead to death; conforming to the principles of yinyang guarantees health, while violating them may result in disease. The movement from conformity to violation is known as interior rejection. Therefore, wise doctors give prevention the priority over treatment, and pay less attention to the treatment of disease but more to the prevention of disease. This is the reason, applying medicine only when disease has emerged, and resorting to treatment when disorder has appeared, are just like drilling a well when one feels thirsty, and manufacturing weapons when war has already broken out. It is certainly to late! Chapter 10 Wu Zang Sheng Cheng Pian (The function of the five viscera to human body and their mutual relations) 是故多食鹹,則脈凝泣而變色。多食苦,則皮槁而毛拔。多食辛,則筋急而爪枯。 多食酸,則肉胝皺而唇揭。多食甘,則骨痛而髮落。此五味之所傷也。 When the salty food is excessively taken, it will cause the stagnation of blood and the eclipse of one’s complexion; when the bitter food excessively taken, it will cause the dryness of the skin and the falling of hair; when the acrid food is excessively taken, it will cause cramp of the tendons and the withering of the nail; when the sour food is excessive taken, it will cause the skin to become tough and thick and the lips wrinkle and shrink; when the sweet food is excessive taken, it will cause the bone pain and the falling of hair. Chapter 11 Wu Zang Bie Lun (The different functions among the Zang-fu organs) For the treatment of a disease, a doctor must get to know the urine and defecation conditions of the patient, feel the pulse, observe the spiritual condition, and ask about the condition of the disease. Those who indulge in superstitions cannot understand the tenets of medicine; those disbelieving acupuncture have no access to this magic skill. Those unwilling to receive treatment cannot be cured and the forced treatment will surely show no effect. 12. 異法方宜論 東方之域,天地之所始生也。魚鹽之地,海濱傍水。 其民食魚而嗜鹹,皆安其處,美其食。魚者使人 熱中,鹽者勝血, 故其民皆黑色疏理,其病皆為癰瘍,其治宜砭石。故砭石者,亦從東方來。 Methods of treatment The east is the direction of the birth of heaven and earth. The weather is mild, and it is close the water. Many varieties of fish and salts can be found, so the local people eat many kinds of fish and like the salty flavour. But because they eat so much fish, which is considered a hot food, heat accumulates and stagnates in the body. They also eat too much salt, which dries, exhausts, and drains the blood. This is why people of the east often have dark skin. The commonly suffered illnesses are boils and carbuncles. The treatment of this disease often utilizes needles made of stone, which come from east. Chapter 21. Jing Mai Bie Lun (Further comments on channel) When the water enters the stomach, it evaporates the refined qi and spread it to the spleen above; and the spleen spreads the essence into the lung above; the lung regulates the water way, and transports the essence to the bladder…… 26. 八正神明論 凡刺之法,必候日月星辰,四時八正之氣,氣定乃刺之。 是故天溫日明,則人血淖液,而衛氣浮。月始 生,則血氣始精,衛氣始行。 是以因天時而調血氣也。 Acupuncture in accordance with cosmic cycles All methods of acupuncture must be in accordance with the movements of the four seasons, the moon, the sun, and the stars. These factors will impact the functions of the human body. During warm weather and bright, cloudless days, blood flow is smooth. The wei qi (defensive energy) floats to the surface... During the full moon, the blood and qi also begin to flow more easily... One must follow these changes of nature to properly regulate qi and blood. Chapter 28 Tong Ping Xu Shi Lun (On the Asthenia and Sthenia) Huang Di asked: “ What is asthenia and sthenia?” Qibo answered: “When the evil Qi is overabundant, it is sthenia. When Vital qi is injured, it is asthenia.” 60. 骨空論 風從外入,令人振寒、汗出、頭痛、身重、惡寒。 治在風府,調其陰陽。不足則補,有餘則寫。大風 頸項痛,刺風府。 風府在上椎。大風汗出,灸噫譆。噫譆在背下俠脊傍三寸所。厭之令病者呼?譆,? 譆應手。 Acupoints along the skeletal indentations When the wind pathogen attacks, it causes chills, sweating, headaches, heaviness, and aversion to wind. One must harmonize the yin and yang by acupuncturing fengfu (DU16), located above the first cervicle vertebra and below the external occipital protuberance. If the antipathogenic qi is weak, one should use the tonification method. If the pathogen is of an excess nature, one should sedate. After a more severe exposures to wind, one will manifest severe neck pain and stiffness. Acupuncture fengfu (DU16) again. If the patient is exposed to a big wind and experiences sweating, the physician should moxa yixi (B45), which is located at the level of the sixth thoracic vertebra, three cun (inch) laterally. Palpate the point to elicit an "yixi" (painful exclamation) expression from the patient. 62. 調經論 人有精、氣、津、液、四肢、九竅、五臟、十六部、三百六十五節, 乃生百病;百病之生, 皆有虛實。皆生於五臟也。夫心臟神,肺臟氣,肝臟血,脾臟肉, 腎臟志。而此成形,志意 通,內連骨髓,而成身形五臟。五臟之道, 皆出於經隧,以行血氣;血氣不和,百病乃變化 而生,是故守經隧焉。 Regulation of the channels In the human being there are jing (essence), qi (energy), jin ye (body fluids), four extremities, nine orifices, five zang organs, sixteen channels, and three hundred and sixty-five joints. All are capable of becoming disordered and diseased. In each disorder there are distinctions of deficiency and excess... The five types of excess and deficiency are borne from the five zang organs. For example, the heart houses the Shen (spirit); the lungs house the qi, the liver accomodates the blood, the spleen houses the form and flesh, and the kidneys house the Zhi (will). They must all function together as the Zhi and the Shen are functioning in concert psychically, connecting with the bones and marrow withing and forming the shape of the body without. This creates an entire functional being and is the makeup of the human body. Within the five zang, communication occurs via pathways or channels, which transport the qi and blood. When the qi and blood are not regulated, illness occurs. Diagnosis and treatment are thus dependent on the channels and pathways. Chapter 71 六元正纪大论 Liu Yuan Zheng Ji Da Lun 黄帝问曰:“妇人重身,毒 之如何?” 岐伯曰:“有故无殒,亦无殒也。” 帝曰:“愿闻其故何谓也?” 岐伯曰:“大积大聚,其可犯也,衰其大半而止,过者死。” Yellow Emperor asked: “What about applying the violent medicine to a pregnant women?” Qibo said: “if the patient has abdominal mass, the violent medicine will suit the disease, both the mother and fetus will be unharmed.” Yellow Emperor asked: “ What is the reason?” Qibo said: “To the diseases of great stagnation and accumulation, the violent medicine can be used as it can remove the disease, but when the disease is removed by a good half already, the applying of medicine should be ceased, if the medicine applying is more than enough, it may cause death of the patient ” 至真要大论 七四 Chapter 74 Zhi Zhen Yao Da Lun 帝曰: 善。 夫百病之生也,皆生于风寒暑湿燥火, 以之 化之变也。岐伯曰: 审察 病机, 无失气宜, 此之谓 也。 帝曰: 愿闻病机如何? 岐伯曰: 诸风掉眩,皆属于 肝。皆寒收引皆属于肾。 Yellow emperor said: “ Good, most of the disease are stemmed from the healthy and evils changes of the six-qi of wind, cold, heat, dampness, dryness and fire. Qi Bo said: “ when one observes carefully the pathology of the disease and treat without violating the principle of the harmonization of the six-qi , the aim can be achieved”. Yellow Emperor said: “Good. Most of the disease stemmed from the healthy and evil changes of the six energy of wind, cold, heat, wetness, dryness and fire. It was stated in the medical books that it should be purged when the energy is over abundant, and should be invigorated when the energy is deficient. I have instructed the physicians with these methods but they cannot obtain a satisfactory result. I would like to have the important theory be put into use and obtain a relating effect like the drumstick relating to the hitting of the drum, produce an immediate effect like pulling off the thorn and clear away the foul, and cause the common physicians to attain a higher level of treating. Can you tell me how to do it?” Qibo said: “When one observes carefully the mechanism of the disease and treat without violating the principle of the harmonization of the sixenergy, the aim can be achieved.” Yellow Emperor said: “I hope to hear about the mechanism of disease you said.” Qibo said: “ 1.All the syndromes of trembling and dizziness caused by the wind evil are pertaining to the liver; 2. all syndromes of muscular stiffness caused by the cold evil are pertaining to the kidney; 3. all the feelings of irritability and oppression caused by the disease of vital energy are pertaining to the lung; 4.all the syndromes of edema and fullness caused by the wetness evil are pertaining to the spleen, all the blurred vision and convulsion of extremities caused by the heat evil are pertaining to the fire 5.all the syndromes of pain, itching, pyogenic infection and ulceration of skin are pertaining to the heart; 6.all the syndromes of cold extremities, retention or incontinence of feces and urine are pertaining to the lower warmer; 7. all the syndromes of rapid breathing, hiccup and vomiting are pertaining to the upper warmer, 8.all the syndromes of trismus, shivering with cold, percussion of the teeth are pertaining to the fire; 9.all the syndromes of convulsive(opisthotonus) disease and stiffness of neck are pertaining to wetness, 10.all the syndromes of adverseness of vital energy are pertaining to the fire; 11.all the syndromes of abdominal distention and fullness are pertaining to the heat; 12.all the syndromes of irritability, uneasiness, mania and acting rashly are pertaining to the fire; 13. all syndromes of sudden muscular stiffness are pertaining to the wind evil; 14.all the diseases with sound, such as borborgmus and the sound like drum beating in percussion are pertaining to heat, 15. all the diseases of edema, aching pain, frightening, uneasiness are pertaining to the fire; all the syndromes of cramp, muscular stiffness, turbidity of the excreted fluid are pertaining to the heat; 16.in all the cases of excreting clear and cold fluid are pertaining to the cold; 17. all the syndromes of acid eructation, sudden diarrhea with urgent sensation are pertaining to the heat. This, it was stated in the (Essentials): ‘Pay good attention to the mechanism of the diseases and know well the belongings of various syndromes, investigate the reason of the disease and the related syndromes, and the reason or the disease which is without the expected syndromes, find out the reason when the evil energy is over abundant and the reason when the energy is deficient. Find out the overcoming energy of the five-element motion. Dredge the energy and blood to become calm and circulate fluently according to the mechanism of the disease. How do you understand the mechanism of disease in this chapter? (quiz) Section III The occurrence of visceral disease is similar to the state of a human body being thorned, and object being contaminated, a piece of rope being knotted or a river being blocked. However, a deep lodged thorn can be pulled out; a long contaminated object can be cleaned; a long knitted knot can be undone; and a long blocked river can be dredged. Some people regard stubborn disease as incurable, this view is incorrect. The skilled acupuncturists cure disease just like pulling out thorns, cleaning contaminated, undoing the knitted knot and removing the blockage. The disease may be prolonged, but still can be cured. Those regarding the prolonged disease as incurable are ignorant of the skill required. Section IV The pathogenic wind, cold, and heat, unless they encounter the weakened physique, can’t be harmful. Those suddenly attacked by storm but not falling ill are usually strong in physique. Thus pathogenic factors in themselves can’t harm people. The contraction of disease is usually instigated by the combination of a pathogen wind with a weak physique. When pathogenic wind meets with the weak body, disease begins to emerge. When normal wind meets with strong physique, people will become even more healthy. The attack of the human body by the asthenic pathogen factors is due to the combination of pathogenic factors in nature with the deficiency of the sthenic pathogens, serious diseases occur. Pathogenic factors attack certain parts of the human body, therefore diseases are named after these parts. Disease can be divided into three categories according to the upper, lower, and middle divisions of the human body. Section V Huangdi asked: “I’d like to know the law of acupuncture.” Qibo answered: “Diseases are sometimes superficial and sometimes deep. So needling is shallow in some cases and deep in some others according to the conditions concerned. …… Thanks